What they're saying in Lansing about Medicaid expansion

Half-truths contain elements of reality that complicate refutation. That's why a half-truth can be worse than a lie. In addition, the art of the half-truth is a longstanding technique of political rhetoric.

Perhaps the most recognizable form of this is when government officials suggest that if they don't get what they want, there will be dire consequences. The classic example is when local officials want voters to pass revenue “enhancements,” such as tax increases or bond proposals.

“If this doesn't pass, we might have to layoff policemen and firefighters,” the voters are told. “Public safety is at stake.”

Sound familiar? In fact, this scenario has been played out so many times that it has often been parodied in literature and movies. Of course, in many cases — if not most — the full list of options officials would face, if their desired measure were defeated, includes making cuts voters might not consider distressing.

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Obviously, if the officials said: “If this or that doesn't pass, we'll have to get rid of unnecessary programs and do things more efficiently,” they wouldn't get the desired reaction.

A recent example of this involves Medicaid expansion, which at the state level is this year's top issue pertaining to Obamacare. Simply put, states that expand Medicaid are cooperating with the federal government's efforts to implement Obamacare. States that refuse to do the expansion aren't. Rejecting the expansion is saying to the feds: “Look, do what you're going to do, but don't expect us to get tangled up in it.”

Gov. Rick Snyder wants Michigan be part of the expansion. He says he dislikes Obamacare, but it's the law of the land. The GOP-controlled Legislature is resisting the push to go along with the expansion. However, they're under a lot of pressure to give in.

Recently, a story emerged in the news media that “inaction” on Medicaid expansion by Michigan lawmakers could result in about 26,000 extremely poor, childless adults without disabilities losing access to health care in 2014.

This is a half-truth. It sets up the premise that, if the lawmakers don't pass Medicaid expansion, then 26,000 people will be put at risk. But that could only happen if the Legislature doesn't pass the expansion and then officials sit on their hands and do nothing.

That's not what has happened in other states that have rejected Medicaid expansion. Instead, they've have made various adjustments to try to cope as best they can. If the expansion isn't passed by the Legislature, Michigan officials would be forced to adjust their plans. Finding other avenues to cover the 26,000 who are supposedly threatened would almost certainly be part of that adjustment.

In Wisconsin, Gov. Scott Walker's approach was to reject the expansion and then reduce the number of people on Medicaid. He's doing this by directing them toward the Obamacare exchange. He figures that the exchange at least offers some individuals a little more flexibility while Medicaid gives them none.

Michigan isn't Wisconsin and no one is suggesting it should adopt Gov. Walker's plan. But the point is that if Medicaid expansion is rejected by the Legislature, policy makers would come up with alternative that fits Michigan.

Interestingly, the Medicaid expansion debate provides an instructive example of the difference between the thinking process of conservatives and liberals. To try to get states to expand Medicaid, the federal government is offering each state hundreds of millions of dollars for Medicaid up front. After the first three years of the expansion, the federal government would supposedly keep funding 90 percent of Medicaid.

Ask liberals, conservatives and everyone in between if they trust politicians. A vast majority will respond with a resounding “no.” But go a step or two beyond that, and the patterns of their thinking processes diverge.

To liberals, when the federal government promises 90 percent of the funding for Medicaid beginning three years from now, it's carved in granite. To the conservative mind it means nothing of the sort — especially when the federal government is $17 trillion in debt.

(Editor’s Note: Jack Spencer is Capitol Affairs Specialist for Michigan Capitol Confidential. He is a veteran Lansing-based journalist. His columns do not represent viewpoints of the Mackinac Center for Public Policy or Michigan Capitol Confidential.)

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